Health anxiety - reining it in while you underg... - Thyroid UK

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Health anxiety - reining it in while you undergo tests: can you?

HowNowWhatNow profile image
83 Replies

I’ve been having lots and lots and lots of investigative tests recently because of being anaemic for a year and because of many other odd symptoms - in more than 1 part of my body - that have yet to be explained away.

I’ve had a mammogram, an endoscopy, a colonoscopy, ECGs, a CT scan (that went wrong), an MRI, at least 4 ultrasounds (of separate parts of the body) and numerous other checks, blood tests and stool tests, just in this one year.

The symptoms, body changes and pains remain and the investigations roll painfully slowly on.

I am due to get some important results back - in a conversation with the relevant specialist doctor - tomorrow. The prospect of this chat tomorrow has been weighing very heavily on me since I had the test done last week, and my attention span has been abysmal (much shorter) during this span and in many other ways I have been catching myself feeling unusually anxious.

How do you all deal with anxieties about things that are happening to your body / mind or that might be happening to you?

I find the fears about cancer sit in a particularly nasty category of anxieties. The cancer ones, for me, are the fears that - when the symptoms are still unexplained - are nastiest of all.

Tests are a horrible waiting game - tell me how you face up to your fears or even how you run away from them! Whatever’s worked for you, I want to hear it, please.

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HowNowWhatNow
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83 Replies

Well, Geogeor, you must have seen as many - ologists as me during this last year. I’ve also seen several in the previous 2 years. I’ve had several diagnoses - Peripheral Neuropathy; nerve entrapment syndrome; Inflammatory bowel disease which I’m able to add to two cancers and osteoporosis which I was diagnosed with ten years ago. My health problems just roll on and on and it gets to the point where if I dwell too much on them I feel miserable. I try to distract myself with hobbies and interests. I’m currently being investigated for a GI cancer and I must admit that I’m not being quite as gung ho about this. I tell myself that if there’s anything there it’s better that it’s found but it’s not easy.

It’s also helpful to acknowledge that someone else is dealing with all this. You’ve done your bit by consulting your doctor and having the appropriate investigations. Don’t worry about what you can do nothing about.

I’m having problems sleeping at the moment as my mind is racing. Last night I decided to play a little word game where I had to find a medical condition I’d been treated for for every letter of the alphabet. It was a bit depressing that I got to Q before failing to find one. I eventually fell asleep after reverting to counting sheep. OH was very amused this morning when I told him about my little game. He thought of a Q word straight away:

Queuing 🤣

HowNowWhatNow profile image
HowNowWhatNow in reply to

Oh Morecambe Bay, you know exactly what I’m talking about.

What is your hair like? My hair is quite unruly. All my life, hairdressers have looked pained when they see me “so how you style it?” or refused to give me certain hair styles, so sure are they that I can’t get away with them.

And it’s a similar thing with doctors’ reactions to a patient with more than one issue. As soon as you have more than one problem, they look so perplexed - as if you are somehow just trying to make their life more difficult.

I’ve never understood that face. Why not rise to the challenge, do your best, be polite and stay quiet?

HowNowWhatNow profile image
HowNowWhatNow in reply to

PS. I’m being investigated for GI things - could be cancer, could be 100 other things, too.The GI diagnosis process seems the least efficient and well-ordered of all areas of medicine. I’m getting one test at a time at 2-3 weekly intervals. Each of which only covers one aspect or part of the GI area. I could still be having tests in 2023, at this rate.

How far into it are you? And which tests have you had done or are you about to have?

in reply to HowNowWhatNow

I’ve had gastroscopy, colonoscopy, abdo CT scan with contrast, ultrasound of gall bladder and many blood tests.

Pain is consistent with Pancreatitis or Pancreatic cancer and stool supports that thinking. Next the C19, amylase and lipase blood tests which are fairly conclusive.

I’m afraid that doctors don’t do much ‘joined up thinking’ and so we have to wait far too long between tests etc. This isn’t good for any health conditions, but sadly some cancers are diagnosed far too late because of this laissez faire attitude.

HowNowWhatNow profile image
HowNowWhatNow in reply to

Yours is exactly my experience of gastro tests.There is no point in having 2 week cancer specialist referral times in the NHS unless the specialist then also motors through tests to their diagnosis.

I now know why so many are diagnosed with cancer after arriving in A&E with a major problem that hasn’t been properly investigated while they were in the community. All of whom have much worse prognoses than any whose cancers are picked up sooner.

When do you expect to know?

in reply to HowNowWhatNow

Seeing doc next week to organise outstanding tests.

HowNowWhatNow profile image
HowNowWhatNow in reply to

Do you mind my asking - there is no TMI here - what it is about the stool that is consistent with pancreatic cancer? Is there blood in it?

in reply to HowNowWhatNow

It’s called Steatorrhea. Yellow stool, often oily, which tends to float.

Hope you’ve had your breakfast 🤣

Tests for Pancreatitis are similar to Pancreatic Cancer as are symptoms.

HowNowWhatNow profile image
HowNowWhatNow in reply to

Oh yes. I’ve heard about that.

Since having had children and changed nappies, talking about poo stuff doesn’t faze me any more than snot or nail clippings would!

How long have you been undergoing tests for - when did your symptoms first arise? Hope you get there soon.

in reply to HowNowWhatNow

January 2020. Was thought to have gall stones but scan of gall bladder revealed nothing. After endoscopy, diagnosed with hiatus hernia and ulcers. No H Pylori. ???? PPI for 5 months didn’t improve anything. Then began to have severe stabbing pain through upper abdomen into back with pain radiating into shoulders.

HowNowWhatNow profile image
HowNowWhatNow in reply to

How has it taken so long to get to where you are now? Covid and waiting lists?My stomach pains began mid July. They weren’t sufficiently investigated when I went to A&E with them twice. And I still - even with private treatment - am not much closer to a diagnosis.

in reply to HowNowWhatNow

Waiting lists and lack of appropriate investigation.

HowNowWhatNow profile image
HowNowWhatNow in reply to

Shocking treatment Have you complained to PALS?

HowNowWhatNow profile image
HowNowWhatNow in reply to HowNowWhatNow

I have found an improvement (slight) when I complained about my GP’s lack of concern for my son

HowNowWhatNow profile image
HowNowWhatNow in reply to

Morecambe Bay,

Can I please ask you a couple of questions about GI diagnoses. So far, my abdomen U/S scan was fine. My endoscopy today was fine. I am now booked in for a small intestine CT scan next week. I have had a positive result for H pylori and one go of pylori meds and don’t yet know whether that was successful.

The GI doctor took biopsies today for H pylori and I don’t know what else. Said it all looked fine.

Symptoms: I have had - since a few months - stomach pain underneath and below my ribs on the right that sometimes encircles my back. And burps and constipation, but the kind that leads to frequent, small bowel movements.

What am I needing doctors to look at, to rule out now, please, when I have the CT scan? And what else if anything have I missed? All I can think of are the pancreas blood tests and a transvaginal scan. Thank you.

in reply to HowNowWhatNow

Hi Geogeor

Happy to discuss this with you but would you mind if we did it via PM?

We’re in danger of drifting ‘off topic’ - also don’t want to put folks off their lunch 🤣

If you send me a PM I’ll know that’s ok with you.

SlowDragon profile image
SlowDragonAdministrator

Looking at previous posts

You have Hashimoto’s

EXTREMELY low ferritin (5)

What about vitamin D, folate and B12

How much Levothyroxine are you currently taking

Always same brand?

Obviously FULL thyroid and vitamin results are essential

Are you taking T3 or NDT

EXACTLY what vitamin supplements

Are you gluten free/dairy free

Are you vegetarian or vegan

You also mentioned heavy blood loss during labour

Testing and possible diagnosis for Sheehan syndrome ?

Personally I was testing for

Cushings

Addisons

MS

MND

Pituitary tumour

Pheocromocytoma

Muscle wasting disease

Etc etc

At the time I had two small children and was almost completely incapacitated

It took months to be referred to each “specialist “ - who just tested for their area of expertise ….then more waiting for next specialist

MS specialist was most helpful and thought I was under medicated for thyroid (on just 75mcg Levothyroxine)

But local diabetic endocrinologist was hopeless

NHS doesn’t look at the whole person

Psychiatrist was totally supportive ….her report got me my referral to my choice NHS 2nd opinion to see thyroid specialist endocrinologist

Final diagnosis

Hashimoto’s - had been left on completely inadequate dose Levothyroxine, multiple vitamin deficiencies, gluten intolerance, DIO2 gene variation

Now on 125mcg Levothyroxine and 20mcg T3, daily vitamin supplements and strictly gluten free diet

HowNowWhatNow profile image
HowNowWhatNow in reply to SlowDragon

Slow Dragon, I’m so sorry but I don’t know where I’ve put my most recent blood test results. When I find them I will report them. And I am so foggy of brain, I don’t remember the exact vitamin type, brand or quantity I am taking. I have just started taking a daily fizzy Vit C pill in water, to aid iron uptake. And a Vit D pill (can’t remember amount) and a slippery

elm pill, the last one on someone here’s recommendation.

When I have discussed the possibility of l Sheehan syndrome with my haematologist, they ruled it out because I was able to breast feed my second child and it was when I had my first child that I lost all the blood.

I mentioned DIO2 to the (thyroid U.K. approved) endo I saw. He ruled that out of hand, too. What are the symptoms or tests for it?

You really went through it ALL, Slowdragon. How many months / years did that take you? And how long were you ill like that for?

I stopped being GF earlier this summer. I’ve never been DF. I don’t always take the same brand of levo. I take what I am given.

SlowDragon profile image
SlowDragonAdministrator in reply to HowNowWhatNow

You can read my profile

5 years extremely unwell often in wheelchair

Following 20 years often very unwell and mobility increasingly poor by 2014

Joined the forum in 2015

Saw just how essential GOOD Vitamin levels were. Mine were poor

Private endoscopy - NHS refused to do as coeliac test was negative. Endoscopy confirmed damage as if coeliac

Strictly gluten free diet since 2016

Full Year improving low vitamin levels to OPTIMAL before being prescribed T3

Initial T3 prescription via private consultation

Private DIO2 gene test AFTER starting T3 - confirmed heterozygous DIO2

Ongoing daily vitamin supplements

NHS agreed to fund T3

Many/most complex hashimoto’s patients

A) must always get same brand Levothyroxine at each prescription

Work out which suits you best

B)regularly retest vitamin D, folate, ferritin and B12

Maintain at OPTIMAL levels

Vitamin D at least around 80nmol and around 100nmol might be better

Folate and ferritin at least half way through range

Ferritin for females- that’s minimum of 70

Serum B12 at least over 500

Active B12 at least over 70

Other supplements to consider

Selenium

Magnesium

Zinc

Strictly soya free for anyone hypothyroid

HowNowWhatNow profile image
HowNowWhatNow in reply to SlowDragon

Thanks for everything, Slow Dragon.

I am sure I have read your profile before. I will read it again, too.

Have never seen a testament to the power of this forum like your account of illness, empowerment and recovery.

HowNowWhatNow profile image
HowNowWhatNow in reply to SlowDragon

Folate: 2.6 (2.10-20.5)B12: 248 (187-883)

Ferritin: 12 (22-275)

HB: 117 (120-150)

MCH: 25 (27-32)

Red blood cell distrib width: 16.8 (11-16)

Serum iron: 5.2 (11-29)

Serum TIBC: 75 (41-77)

Transferrin saturation index: 7 (9-47)

I have (normal) white blood cell results, too, if interesting.

And thyroid:

TSH: 2.16 (0.27-4.2)

Free T3: 4.1 (3.1-6.8)

Free T4: 17 (10-23)

SlowDragon profile image
SlowDragonAdministrator in reply to HowNowWhatNow

TSH: 2.16 (0.27-4.2)

Free T3: 4.1 (3.1-6.8)

Free T4: 17 (10-23)

How much levothyroxine are you currently taking

Ft4 is only 53% through range

Ft3 is only 27% through range

Helpful calculator for working out percentage through range

chorobytarczycy.eu/kalkulator

So you need 25mcg dose increase in levothyroxine to increase Ft4

Poor conversion of Ft4 to ft3 can be improved by improving your very low vitamin levels

Bloods should be retested 6-8 weeks after dose increase in levothyroxine

Meanwhile working on improving very low vitamin levels by supplementing

Folate: 2.6 (2.10-20.5)

B12: 248 (187-883)

Ferritin: 12 (22-275)

HB: 117 (120-150)

MCH: 25 (27-32)

Red blood cell distrib width: 16.8 (11-16)

Serum iron: 5.2 (11-29)

Serum TIBC: 75 (41-77)

Transferrin saturation index: 7 (9-47)

Ferritin is deficient and you almost certainly need iron supplements

With tag humanbean and SeasideSusie to comment on iron and ferritin

Folate is deficient

B12 extremely low

GP should prescribe folic acid. Likely to need B12 injections, or certainly daily B12 supplements

Essential to test vitamin D

vitamindtest.org.uk

Test twice yearly via NHS private testing service when supplementing

HowNowWhatNow profile image
HowNowWhatNow in reply to SlowDragon

Very much appreciated.

I do not tolerate oral iron supplements. They make me very ill. The above ferritin level was the highest result I’ve had all year. Ferritin can go up when you have inflammation - I wonder if it was that.

Since these blood tests were taken, I have had an iron infusion.

For my thyroid I take 150 mcg levo a day.

I don’t take B vitamins but it looks like I should. I do take Vit D but haven’t had that level tested in a few years.

I am not sure whether my GP will raise my TSH dose but I will try. When I discussed this with them they said I should stay on the same dose.

Some question - blood loss in childbirth - in my mind about whether I need to be investigated for secondary hypothyroidism. Someone wrote a great summary for me here about Sheehan’s syndrome.

SlowDragon profile image
SlowDragonAdministrator in reply to HowNowWhatNow

Well you need fully iron panel test before starting any iron supplements

humanbean may pop by with info on why so important

How much levothyroxine are you currently taking

How much do you weigh in kilo approx

HowNowWhatNow profile image
HowNowWhatNow in reply to SlowDragon

60 kgAnd 173 cm

HowNowWhatNow profile image
HowNowWhatNow in reply to SlowDragon

I can’t take iron supplements any more. They make me so ill!I am going to take tranexamic acid and try to get a Mirena coil so that I don’t lose more iron every month.

SlowDragon profile image
SlowDragonAdministrator in reply to HowNowWhatNow

What’s your diet like

Obviously not absorbing much in way of nutrients

Are you vegetarian or vegan

HowNowWhatNow profile image
HowNowWhatNow in reply to SlowDragon

Healthy. My husband and children are not unwell.

Have increased my meat intake following being anaemic for the last year and prior to that being anaemic on/off for the last few years.

HowNowWhatNow profile image
HowNowWhatNow in reply to HowNowWhatNow

Not vegetarian or vegan. Eat a big (home cooked) supper in the evening and a sandwich or something else that’s light for lunch.

Two coffees a day and two cups of tea are my main indulgences.

SlowDragon profile image
SlowDragonAdministrator in reply to HowNowWhatNow

Don’t start any B vitamin supplements until GP has tested

Once you get full testing done for Pernicious Anaemia via GP

If GP won’t test or won’t prescribe B12 supplements or injections

Low B12 symptoms

b12deficiency.info/signs-an...

And once finished folic acid prescriptions

If serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months, then once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.

B12 sublingual lozenges

amazon.co.uk/Jarrow-Methylc...

cytoplan.co.uk/shop-by-prod...

healthunlocked.com/thyroidu...

HowNowWhatNow profile image
HowNowWhatNow in reply to SlowDragon

Can you explain how I am B12 deficient despite notionally being within the healthy range, please?

HowNowWhatNow profile image
HowNowWhatNow in reply to SlowDragon

This is all a) incredibly helpful and b) news to me.

HowNowWhatNow profile image
HowNowWhatNow in reply to SlowDragon

Do you mind telling me what kind of job you did in a parallel universe? I am fascinated to know.

What I realise - reading about B12 - is that it is a condition that PPIs would make worse.

I had to take omeprazole (a PPI?) in early September because of an H Pylori infection. And I was much worse after a week taking it. I also had to take it last autumn.

SlowDragon profile image
SlowDragonAdministrator in reply to HowNowWhatNow

Have you had dose increase in levothyroxine since these results

TSH is far too high for someone on levothyroxine

Ft4 and Ft3 too low

How much levothyroxine were you taking when these results were done

Have you had dose increase since

HowNowWhatNow profile image
HowNowWhatNow in reply to SlowDragon

The most recent thyroid tests I have had say: TSH 1.4

Free T4 16

That’s all that was measured.

I have some other less recent results, which I’ll look out now.

Thank you.

HowNowWhatNow profile image
HowNowWhatNow in reply to HowNowWhatNow

Many of the other things tested for were less usual things like Hep A and B and other auto-immune conditions.

I won’t include them because they were all fine but the results that stood out, because too high, are:

Transferrin 56 (25-50%)

Serum iron 34.3 (15-30) umOL

IgM 2.91 (0.53-2.23) g/L

I had just had an infection and finished a course of antibiotics for it. Would this explain the high IgM?

I also had an iron infusion in September. I wonder whether this explains the high transferrin and serum iron levels?

Also

B12 371 (200-770)

Folate 3.4 (3-20)

And

Ferritin 39 (13-150) [shocking - 13 is considered normal?]

I am having some new quite concerning symptoms in the mouth and throat and have spotted a lump in the back of the neck. These don’t seem to be connected to my thyroid. But I know, at this stage, less than nothing about what is happening / causing it - 1) the ultrasound done of my thyroid and of the glands at the front of the neck was fine, and 2) they didn’t check the back of the neck then and 3) I think my Sjogren blood tests came back negative which meant that 4) the consultant said I didn’t need a lip biopsy. Annoyingly I only felt the lump in the back of my neck the day after I saw the specialist. I am now hoping to get an MRI of the neck / throat done this week.

Thanks as ever

SlowDragon profile image
SlowDragonAdministrator in reply to HowNowWhatNow

Obviously just testing TSH and Ft4 is completely inadequate

cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

Always test thyroid levels as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Only test early Monday or Tuesday morning and then post back via tracked postal service

B12 371 (200-770)

Folate 3.4 (3-20)

Ferritin 39 (13-150)

What vitamin supplements are you currently taking

You need vitamin D tested too

How much vitamin D are you currently taking

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Clearly folate and B12 are too low and need improving

Are you currently taking B12 supplement and daily vitamin B complex?

HowNowWhatNow profile image
HowNowWhatNow in reply to SlowDragon

I’m taking vitamin D, a multivitamin and a starflower oil supplement. Will check if my multi Vit has vit B in it. And what level of D I take. Thanks.

The excellent GP I spoke to this week who only works in our practice 1 day a fortnight it seems (shout out to all the extremely brilliant GPs like her, but consistency is so important when you are in a complicated medical situation) has just sent me off to have more blood tests for:

Oestradiol

Gonadotrophin

CRP

Thyroid profile

Parathyroid

Prolactin

And

HBA1c

I should have those results back mid-week.

SlowDragon profile image
SlowDragonAdministrator in reply to HowNowWhatNow

We never recommend multivitamins to any hypothyroid patients on here

Far too little of what we do need.

Usually cheap, poorly absorbed ingredients

Most contain iodine not recommended for anyone with Hashimoto’s

Multivitamins are useless for anyone actually low in vitamins…..As demonstrated by you ongoing extremely low vitamin levels

Suggest you stop the multivitamins

Instead

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial. This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid

chriskresser.com/folate-vs-...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Thorne Basic B or Jarrow B Right are recommended options that contains folate, but both are large capsules. (You can tip powder out if can’t swallow capsule)

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Low B12 symptoms

b12deficiency.info/signs-an...

With serum B12 result below 500, (Or active B12 below 70) recommended you should also be taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months, then once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.

B12 sublingual lozenges

amazon.co.uk/Jarrow-Methylc...

cytoplan.co.uk/shop-by-prod...

healthunlocked.com/thyroidu...

Meanwhile

Get vitamin D levels tested

Aiming for vitamin D at least around 80nmol and around 100nmol maybe better

Come back with new post once you get vitamin D results and TSH, Ft4 and Ft3 tested together via Monitor My Health

Highly likely you are still under medicated thyroid wise

HowNowWhatNow profile image
HowNowWhatNow in reply to SlowDragon

Thank you, SlowDragon.

My multivitamin is the cheapest offering Lidl can do. On the plus side it doesn’t contain iodine. It says it contains 100% of recommended B12, B2 and B6, among others, but I will invest in something better.

The Vit D I take is 25 funny symbol g / dose (500% of NRV). Again super cheap and I’ll upgrade.

SlowDragon profile image
SlowDragonAdministrator in reply to HowNowWhatNow

Buying online is good price and good quality

Vitamin B complex

Jarrow B right

amazon.co.uk/Jarrow-Formula...

Might get cheaper if shop around

Or check health shop

Or try Thorne

Thorne always more expensive

Again might get cheaper if shop around

amazon.co.uk/Thorne-Researc...

Vitamin B complex will almost always turn your urine yellow….don’t be surprised/concerned

SlowDragon profile image
SlowDragonAdministrator in reply to HowNowWhatNow

B12 options I already gave you in reply above

Vitamin D

25ug is only 1000iu

nafwa.org/vitamind.php

Test your vitamin D level

See what result is

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7. One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

Better You vitamin D often on offer in Holland and Barrett as 3 for 2

But suggest you just buy one initially to check you get on with it

SlowDragon profile image
SlowDragonAdministrator in reply to HowNowWhatNow

As this included thyroid test…..was this test done 8-9am before taking daily levothyroxine

HowNowWhatNow profile image
HowNowWhatNow in reply to SlowDragon

I thought I’d replied to this.

All most recent test results done at about the same time - at about 4 / 5 pm.

I take levo at night.

SlowDragon profile image
SlowDragonAdministrator in reply to HowNowWhatNow

Median TSH graph in healthy population healthunlocked.com/thyroidu...

TSH has pronounced daily variation

healthunlocked.com/thyroidu...

It’s very important when in day you test TSH ....should always test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning,

delay Saturday evening dose levothyroxine until Sunday morning.

Delay Sunday evening dose levothyroxine until after blood test on Monday morning.

Take Monday evening dose levothyroxine as per normal

researchgate.net/publicatio...

According to the current TSH reference interval, hypothyroidism was not diagnosed in about 50% of the cases in the afternoon.”

“Further analysis demonstrated inadequate compensation of hypothyroidism, which was defined in 45.5% of the morning samples and in 9% of the afternoon samples”

If delaying taking levothyroxine until after blood test, you likely want to not eat or drink anything apart from water before taking levothyroxine

It may (or may not) make a difference to TSH if fasting ….opinions differ

ncbi.nlm.nih.gov/labs/pmc/a...

ncbi.nlm.nih.gov/pubmed/252...

HowNowWhatNow profile image
HowNowWhatNow in reply to SlowDragon

I have only just had my thyroid blood tests done and this totally slipped my mind - grrr. I have booked the Vitamin D test. An expensive day!

HowNowWhatNow profile image
HowNowWhatNow in reply to SlowDragon

Have you or the rest of the forum thought of setting up an Amazon shop where all the things you recommend are in one place? And where a proportion of what we buy comes back to .. a thyroid charity? I need a good reason to shop there.

SlowDragon profile image
SlowDragonAdministrator in reply to HowNowWhatNow

Shop through Amazon smile and then choose Thyroid U.K. as your charity

smile.amazon.co.uk/gp/chpf/...

thyroiduk.org/help-us-to-he...

As of today Thyroid U.K. has received £2200 approx via Amazon Smile

HowNowWhatNow profile image
HowNowWhatNow in reply to SlowDragon

Thank you

Jazzw profile image
Jazzw

I get it Georgeor. With the notable difference that I have literally given up on doctors. I have no faith in them spotting anything. They missed my mother’s cancer. They missed my husband’s cancer. If my father hadn’t paid privately for an MRI on his hip which showed up a mass in his bladder they’d have missed his cancer too.

I know they’ve got an uphill task, trying to work out which of the 100s of patients they see every week really has something wrong with them, and which have something which is self-limiting and will fix itself given time.

But both my mother and my husband presented with symptoms that weren’t taken seriously, brushed under the carpet. Neither were the sort to go to the doctor’s with something trivial (far from it). Yet they were both treated as though they were malingerers. My Dad’s cancer developed during the pandemic and even though he was attending his practice every week to get a leg ulcer dressed he could not, even begging, get a face to face appointment with a doctor, despite escalating symptoms and unbearable pain. Time will tell as to whether he had surgery in time. My mother survived 2 years after diagnosis. My husband survived less than 3 weeks.

I’m feeling so incredibly low at the moment and ridiculously tired and headachy. My latest round of thyroid and vitamin blood tests don’t actually look too bad—nothing obvious there except a ferritin level that could probably do with a slight boost. If I thought for a second there was any point to going to the doctor with such vague symptoms… well, let’s get real. I don’t.

No point to this really except to say, I hear you. And maybe this is just what it’s like to be a 51 year old woman (menopause happened nearly five years ago, just after my husband died, so it’s not that).

Crap, isn’t it?

HowNowWhatNow profile image
HowNowWhatNow in reply to Jazzw

Oh Jazz W, I’m so sorry.

I know what you mean about the carpet brushing under. I’ve been there.

But I’m so sorry that poor diagnosis / incompetent doctors had such life-changing results for the life of your mother and husband.

The NHS is on its knees, has been for a while, but it is still shocking to hear the stories we hear here every day.

All this said, please do go to your GP if you think there is something else that is wrong. Please!

humanbean profile image
humanbean in reply to Jazzw

With the notable difference that I have literally given up on doctors. I have no faith in them spotting anything. They missed my mother’s cancer. They missed my husband’s cancer.

My experience is similar...

They missed my mother's cancer and my mother-in-law's cancer. My mother lived for about 7 months after finally getting a diagnosis, and my mother-in-law lived for less than three months. Both were treated as if they were attention-seeking malingerers for many months before finally getting a diagnosis.

Doctors are encouraged by the CCGs and the government not to refer to secondary care. And as we know, even if someone is referred, they are often refused treatment.

I think that current government policy is to drive as many people into the private sector as possible by making it impossible for the NHS to treat through lack of staff and money. And the government wants people to hate the NHS so they can shut it down and make it all private. But what percentage of the population can afford private treatment? I think it must be tiny. But the thing is that I don't hate the NHS. I hate the medical profession for the never-ending gaslighting, disbelief, rudeness, insults, dismissal, and the apparent total incompetence.

HowNowWhatNow profile image
HowNowWhatNow in reply to humanbean

The incentives are all in the wrong places.No-one is paid for giving good treatment, they are paid for telling people that the chances of them being seriously ill are small, and they don’t want to consider the possibility that the person is in that bracket.

If you wait long enough to refer your patient, they’ll be dead anyway, so why refer? Seems to be the logic behind the attitude we see.

Jazzw profile image
Jazzw in reply to HowNowWhatNow

Spot on.

HowNowWhatNow profile image
HowNowWhatNow in reply to Jazzw

How are you now, Jazzw?

Buddy195 profile image
Buddy195Administrator

I just wanted to reach out to you Geogeor, as I also have suffered with terrible anxiety. My GP diagnosed ‘health anxiety’, but most of my symptoms were related to being under medicated thyroid wise. I had some CBT with a psychotherapist which did help me cope with anxiety symptoms better; have you been offered this?

HowNowWhatNow profile image
HowNowWhatNow in reply to Buddy195

Hi Buddy

I haven’t asked, no.

I don’t mean to sound like a crushed victim but I find that one of the side effects of endless waiting times (NHS) and poor case admin / management is that you give up hoping for more than the minimum service level.

How did you know when your thyroid levels were optimal? What level was your TSH eg? And who helped you get there?

Buddy195 profile image
Buddy195Administrator in reply to HowNowWhatNow

Members of this forum helped me Geogeor. I followed advice to test privately for antibodies, T3, T4 and key vitamins (I used Medichecks for this), posted results on the forum and then supplemented to improve vitamins (following advice of SeasideSusie ) I then went to my GP/ endo armed with results/ facts to improve my thyroid medication. I only felt well when TSH was under 1, key vitamins optimal and T3 and T4 higher in range.

HowNowWhatNow profile image
HowNowWhatNow in reply to Buddy195

Thank you for explaining

SlowDragon profile image
SlowDragonAdministrator in reply to HowNowWhatNow

For good conversion of Ft4 to Ft3 we need good vitamin levels

For good vitamin levels we need good Ft3

It’s chicken and egg

Being under medicated for thyroid results in low stomach acid, poor nutrient absorption and low vitamin levels

Improving low vitamin levels is essential and frequently enables increase in levothyroxine

Just testing TSH and Ft4 doesn’t show if you have good or poor conversion

Ft4 16

Please add range on this result

Was test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Almost certainly very poor conversion as vitamin levels are so low

HowNowWhatNow profile image
HowNowWhatNow in reply to SlowDragon

Range FT 4: 12-22

SlowDragon profile image
SlowDragonAdministrator in reply to HowNowWhatNow

Ft4 16 (12-22)

Ft4 is only 40% through range

Helpful calculator for working out percentage through range

thyroid.dopiaza.org

That’s highly unlikely high enough dose

Most people when adequately treated will have Ft4 at least 60-70% through range

TSH falsely low as tested late afternoon

Likely TSH would have been at least over 2 at 8-9am

TSH should be under 2 as an absolute maximum when on levothyroxine

gponline.com/endocrinology-...

Replacement therapy with levothyroxine should be initiated in all patients to achieve a TSH level of 0.5-2.0pmol/L.

NHS England Liothyronine guidelines July 2019 clearly state on page 13 that TSH should be between 0.4-1.5 when OPTIMALLY treated with just Levothyroxine

Note that it says test should be in morning BEFORE taking levothyroxine

Also to test vitamin D, folate, B12 and ferritin

sps.nhs.uk/wp-content/uploa...

Graph showing TSH in healthy population is 1-1.5

web.archive.org/web/2004060...

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

SlowDragon profile image
SlowDragonAdministrator

TSH 2.16

T3 4.1

T4 17

Serum iron 5.2

Serum TIBC 75

Transferrin saturation 7%

HB 117

MCV 79

MCH 25

Red blood cell width 16.8%

Ferritin 12 (my highest ferritin result all year)

Folate 3.6

B12 248

My phone battery is very low so I will put these basic results up now and enter ranges for each later.

Are these your most recent results

Please add ranges

Ferritin dire

Recommend reading many posts and replies by humanbean on how to get ferritin increase

Are you vegetarian or vegan

What iron supplements are you currently taking

Folate and B12 clearly far too low

Are you taking daily vitamin b complex and separate B12

Remember to stop taking vitamin B complex week before test as contains biotin

No vitamin D result

TSH too high

Ft4 and FT3 look low, need ranges

Likely to need dose increase in Levothyroxine

humanbean profile image
humanbean

Serum iron 5.2

Serum TIBC 75

Transferrin saturation 7%

HB 117

MCV 79

MCH 25

Red blood cell width 16.8%

Ferritin 12 (my highest ferritin result all year)

Folate 3.6

B12 248

Although having the ranges for these results would help, assuming they are fairly average ranges then all these results are absolutely dreadful, but I'll wait to see what the ranges are before commenting on them.

I could be confusing you with someone else, but did you say in one of your posts that you lost 1.6L of blood during childbirth?

One possible consequence of such a large blood loss is developing a condition called Sheehan's Syndrome.

en.wikipedia.org/wiki/Sheeh...

The large blood loss causes necrosis of the pituitary, and as a result the person ends up with hypopituitarism i.e. low levels of the hormones produced by the pituitary. It can end up with one hormone being low, or several, or all of them. For such a tiny organ it produces a large number of hormones.

en.wikipedia.org/wiki/Pitui...

en.wikipedia.org/wiki/Anter...

en.wikipedia.org/wiki/Poste...

en.wikipedia.org/wiki/Hypop...

In the above link, in the causes section (vascular), it says :

As a pregnancy comes to term, a pregnant woman's pituitary gland is vulnerable to low blood pressure, such as may result from hemorrhage; pituitary damage due to bleeding after childbirth is called Sheehan's syndrome.

Like so many other problems that only affect women it can be very difficult to get a diagnosis of Sheehan's Syndrome (if it applies - please remember I'm not a doctor). I suggested this diagnosis to another member of the forum (unfortunately I can't remember her name), and after a long time she did manage to get tested and diagnosed but it was a huge struggle for her.

Some other links :

pituitary.org.uk/informatio...

pituitary.org.uk/media/4597...

I just looked up "normal" levels of blood loss during pregnancy and found this :

healthline.com/health/pregn...

which says half a litre or more is a haemorrhage, and yours was over three times that amount.

HowNowWhatNow profile image
HowNowWhatNow

Hi

Yes I spoke to a specialist (haematologist) about the possibility of Sheehan’s and they said that if you are able to breast feed after a major blood loss, you don’t have Sheehan’s. I managed to do so twice, so by that logic I don’t have it.

Thank you for all your attention to detail.

More than I pay to my own health.

Jazzw profile image
Jazzw in reply to HowNowWhatNow

That’s a classic case of confusing cause with effect. Not being able to breastfeed can indicate Sheehan’s. However, that doesn’t mean that if you can breastfeed you don’t have Sheehan’s.

Someone’s read that, got it confused and has stated their misunderstanding as fact. You despair really. :(

I definitely wouldn’t rule out Sheehan’s as the original cause.

HowNowWhatNow profile image
HowNowWhatNow in reply to Jazzw

Oh really?

The person I spoke to is a very senior doctor - teaching positions and consultant.

How do you test for this? I can investigate this - you don’t need to, if you don’t know.

Jazzw profile image
Jazzw in reply to HowNowWhatNow

I would say there’s a couple of ways—testing pituitary function and/or CT scan/MRI of your pituitary.

But a CT/MRI might not show anything up and the pituitary function tests might not be conclusive.

I thought this was quite interesting when I looked it up:

“In most cases, the symptoms of Sheehan syndrome do not appear until months or even years after severe blood loss after childbirth (postpartum hemorrhage). In rare cases, the symptoms of Sheehan syndrome occur within days and include an inability to produce breast milk, a drop in blood pressure, visual problems, and unconsciousness. These symptoms may be life threatening. In other cases, severe symptoms become apparent when the body is stressed by infection or surgery some period of time after delivery.”

rarediseases.info.nih.gov/d...

Sort of knocks your haematologist’s idea on the head (another cause of Sheehan’s by the way :) )—they were thinking of that rarest of cases rather than what more frequently happens with Sheehan’s.

To be honest, this largely boils down to whether this is a secondary hypothyroidism problem (i.e, pituitary failure) rather than primary hypothyroidism (where the thyroid itself is at fault). In a way, it doesn’t matter what causes secondary hypothyroidism as the treatment is the same—except, in the case of secondary hypothyroidism you can rely even less on what the level of TSH is telling you about the adequacy of thyroid hormone replacement.

HowNowWhatNow profile image
HowNowWhatNow in reply to Jazzw

Such an extremely thorough and helpful response. Thanks!

HowNowWhatNow profile image
HowNowWhatNow in reply to Jazzw

Love the head knock ✊ 🙇gag

Jazzw profile image
Jazzw in reply to HowNowWhatNow

Completely accidental—but it worked. 😂

HowNowWhatNow profile image
HowNowWhatNow in reply to Jazzw

Good to know

humanbean profile image
humanbean

One thing I could mention here is that you have every reason to be anxious about your health.

And another thing... When I was suffering from below-range iron and very low in range ferritin, my anxiety was through the roof too. The anxiety diminished the more I raised my iron and ferritin. My very low iron and ferritin was caused by a GI bleed, and I was bleeding for several years before the cause was found - a very large polyp. When it was removed and the bleeding finally stopped I was more or less left to my own devices to raise my iron and ferritin myself.

HowNowWhatNow profile image
HowNowWhatNow in reply to humanbean

Thanks Human Bean. Where was your polyp, out of interest? My knowledge of where you can get polyps is next to non-existent. Am glad you got your levels up to normal eventually.

humanbean profile image
humanbean in reply to HowNowWhatNow

I think polyps of the kind I had are generally found in the bowel (as mine was). Luckily mine wasn't malignant. I haven't heard of them being found in the intestines, the stomach or the oesophagus, but then I haven't really looked for info on other sites where they might be found.

HowNowWhatNow profile image
HowNowWhatNow in reply to humanbean

Thank you. I think people can get them in their ovaries, too.

HowNowWhatNow profile image
HowNowWhatNow

Thank you to everyone who commented on this thread.

So many worrying stories shared here about experiences of waiting for results and slow diagnoses and fighting for answers.

I drew so much sympathy and comfort from all your words.

We often talk about social media as a force for ill / social estrangement.

And yet I very well know the mirror image of those criticisms, judged by the work you all do to help one another here.

The results I have been waiting for since mid July for one area of my body are in, and they are fine. I don’t have the type of cancer I was being tested for there. I still have another part of the body that I’m having investigations on. I will come back and read this thread in the weeks to come!

helvella profile image
helvellaAdministratorThyroid UK in reply to HowNowWhatNow

It was a delight to read that response.

Imaaan profile image
Imaaan in reply to HowNowWhatNow

Good news indeed and a cause for celebration...

Imaaan profile image
Imaaan

I used 2 iron pills before my stomach fiascoes began. Now I cant tolerate one. I load up on red meat and more importantly eat lamb liver which is a game changer. I like to eat oranges right after since iron and vit c go hand in hand. Also I always take probiotic and digestive enzyme to help break it down in the stomach.

Liver is excessive in Vit A, so space it out, if you decide to include it in your diet.

HowNowWhatNow profile image
HowNowWhatNow in reply to Imaaan

Thank you. Have you tried any liquid iron? I also eat lots of meat but think I need to take liquid iron, too, to ensure I don’t go into the danger zone again.

HowNowWhatNow profile image
HowNowWhatNow in reply to HowNowWhatNow

I eat meat out of necessity - I didn’t used to pre-iron deficiency. And also find liver very helpful.!

Imaaan profile image
Imaaan in reply to HowNowWhatNow

Nope never tried it....too chicken. I dont want to upset my tummy and ive been a lil sensetive to a few supplement and meds before. Plus loading up on meat and eating liver brings me easily over the 60% range thank God.

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